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► Med - Anatomy & Physiology > Cardiovascular Risk Factors > Flashcards

Cardiovascular Risk Factors Flashcards

1
Q

Name a progressive disease that is characterised by a buildup of plaque within the arteries?

A

Atherosclerosis

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2
Q

What 5 substances form plaque?

A
  1. Fatty substances
  2. Cholesterol
  3. Cellular waste
  4. Calcium
  5. Fibrin
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3
Q

What two things can happen to a plaque (atherosclerosis) and what does that lead to?

A
  1. Bleeding into the plaque
  2. Formation of a clot on the surface of the plaque

Heart attack or stroke

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4
Q

What is the term used to describe the formation of an acute thrombus in a vessel affected by atherosclerosis, a process common to a number of CV disorders?

A

Atherothrombus

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5
Q

What is the atherothrombotic process initiated by?

A

Changes in vessel wall resulting from plaque disruption

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6
Q

What components can the atherosclerotic plaque expose when it becomes unstable and ruptures?

A

Collagen and von Willebrand factor

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7
Q

What two substances allow platelets to adhere to the damaged area and initiate thrombus formation?

A

Collagen

Von Willebrand factor

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8
Q

What can a thrombus extending and occluding the vessel lead to?

A

Acute ischaemia and tissue injury

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9
Q

What is the term for thrombosis superimposed on atherosclerosis?

A

Atherothrombosis

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10
Q

What three conditions can result if there is a fibrous plaque, atherosclerotic plaque?

A
  1. Angina
  2. Transient ischaemic attack
  3. Claudication/PAD
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11
Q

What might cause ischaemia in distal vascular beds?

A

Embolisation of platelets or fibrinous material from ulcerated plaques

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12
Q

What are the clinical effects of atheroma in retinal arteries?

A

Imparied vision

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13
Q

What are the two clinical effects of atheroma in renal arteries?

A

Hypertension and renal failure

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14
Q

What are the clinical effects of atheroma in mesenteric arteries?

A

Mesenteric ischaemia

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15
Q

What are the two clinical effects of atheroma in femoral arteries?

A

Claudication

Gangrene

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16
Q

What are the two clinical effects of atheroma in aorta/iliac arteries?

A

Intermittent claudication

Gangrene

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17
Q

What are the clinical effects of atheroma in coronary arteries?

A

Ischaemic heart disease

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18
Q

What are the two effects of clinical atheromas in the cerebral/carotid arteries?

A

Transient ischaemic attack

Strokes

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19
Q

In the pathogenesis of atherosclerotic plaques: what protective response results after endothelial damage?

A

Production of cellular adhesion molecules

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20
Q

What can these factors all potentially cause - hypertension, vasoactive substances, mediators (cytokines) from blood cells, cigarette smoke, atherogenic diet, elevated glucose levels and oxidised LDL-C?

A

Damage to endothelium of arterial walls resulting in endothelial dysfuncion

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21
Q

Name two cytokines expressed by endothelila cells after vessel damage?

A
  1. IL-1

2. TNFalpha

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22
Q

What three chemokines are expressed by endothelial cells after damage to vessel walls?

A
  1. Monocyte chemoattractant factor
  2. MCP-1
  3. IL-8
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23
Q

What two growth factors are expressed by endothelial cells as a result of vessel damage?

A
  1. Platelet-derived growth factor PDGF

2. Basic fibroblast growth factor BFGF

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24
Q

What is decreased by endothelial cells, as a response to oxidative stress in the vessel wall?

A

Production of NO, a vasodilator

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25
Q

What two substances are increased by endothelial cells, as a result of opxidative stress in the vessel wall?

A

Endothelin

Angiotensin II

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26
Q

What two local mediators are increased by endothelial cells, as a result of oxidative stress on the vessel wall?

A
  1. Vascular cell adhesion molecule (VCAM)

2. Plasminogen activator inhibitor 1 (PAI-1)

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27
Q

What are the levels of HDL, LDL and triglycerides in dyslipidaemia?

A

HDL is low
LDL is high
Triglycerides are high

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28
Q

What are the big 4 CV risk factors?

A
  1. High blood pressure
  2. Hypercholesterolaemia
  3. Smoking
  4. Diabetes/obesity
29
Q

Are VLDL and Chylomicrons atherogenic?

A

No

30
Q

What carries cholesterol away from the arterial wall and is protective?

A

HDL

31
Q

Which lipoproteins are the lowest in density, and biggest in size?

A

Chylomicrons

32
Q

What lipoproteins are involved in the recycling of cholesterol by the liver as well as formation of LDL in blood?

A

IDL - intermediate-density lipoprotein

33
Q

Which lipoprotein is strongly associated with atherosclerosis?

A

LDL

34
Q

What is the normal triglyceride level and what does high triglyceride increase the risk of?

A

2.3 mmol/l

Pancreatitis

35
Q

What is the exogenous metabolic pathway concerned with?

A

The transport and utilisation of dietary fats

36
Q

What is the analogous particle that transports triglycerides from the liver to the rest of the body?

A

VLDL

37
Q

During what process are triglycerides removed from the core and exchanged for cholesterol esters, prinipally from HDL?

A

Endogenous pathway of lipid metabolism

38
Q

Is total cholesterol a modifiable risk factor?

A

Yes

39
Q

What is the primary target (cholesterol) to prevent CHD?

A

LDL-C

40
Q

What is xanthelasma a clinical marker for?

A

Dyslipidaemia

41
Q

What are tendon xanthomas?

A

Diffuse infiltration of tendon by lipid

42
Q

What are tuberous xanthomas?

A

Lipid deposits in the dermis and subcutis; papuler, nodular or plaques; extensor surfaces of large joints, hands, buttocks, heels and flexures

43
Q

What two things can tuberous xanthomas be a sign of?

A
  1. Familial or acquired hypertriglycerdemias

2. Biliary cirrhosis

44
Q

What are eruptive xanthomas, and what do they indicate?

A

Small reddish/yellow papules found on buttocks, posterior thighs and body folds

Usually abrupt increase in serum triglyceride levels

45
Q

What sign of dyslipidaemia can you find on palms?

A

Striate palmar xanthomas

46
Q

What are the two types of hypertension?

A
  1. Essential - no underlying cause

2. Secondary - underlying cause

47
Q

What 5 substances can be included to diet to reduce obesity and CHD?

A
  1. Micronutrients
  2. Antioxidants
  3. Omega 3 and 6
  4. Polyuinsaturates
  5. Monounsaturates
48
Q

What type of diet protects against CHD and is rich in fruits, vegetables, fish, grains and beans?

A

Mediterranean

49
Q

To achieve a diagnosis of metabolic syndrome, what characteristics msut a patient have 3 or more of (include values)?

A
  1. Abdominal obesity
  2. Triglycerides : > 1.7 mmol/l
  3. HDL-C : 130/>85 mmHg
  4. Fasting glucose : >5.6 mmol/l
50
Q

What may homocysteine undergo remethylation to form, and what two substances does this process require?

A

Methionine

B12 and folic acid

51
Q

What is used to assess a patients CV risk score?

A

Assign score

52
Q

What is the most common cause of premature death?

A

Coronary heart disease

53
Q

What are stenosis, thrombosis, aneurysm, dissection, embolism and ischaemia all complications of?

A

Atheroma

54
Q

What involves narrowing of the arterial lumen, reduced elasticity, reduced flow in systole and tissue ischaemia?

A

Arterial stenosis

55
Q

What leads to reduced exercise tolerance, angina, unstable angina, infarct and cardiac failure?

A

Cardiac ischaemia

56
Q

Give 4 features of cardiac fibrosis?

A
  1. Loss of cardiac myocytes
  2. Replacement by fibrous tissue
  3. Loss of contracility
  4. Reduced elasticity and filling
57
Q

What 4 arteries are mainly affected by arterial stenosis?

A
  1. Coronary arteries
  2. Carotid arteries
  3. Renal arteries
  4. Peripheral arteries
58
Q

What are 3 results of arterial stenosis in the carotid arteries?

A
  1. Transient ischaemic attack
  2. Stroke
  3. Renal failure
59
Q

What are two results of arterial stenosis in renal arteries?

A
  1. Renal failure

2. Hypertension

60
Q

What are two results of arterial stenosis in peripheral arteries?

A
  1. Claudication

2. Foot/leg ischaemia

61
Q

What does plaque rupture often trigger?

A

Thrombosis

62
Q

What can cause MI, cerebral infarction, renal infarction and bowel infarction?

A

Arterial thrombosis

63
Q

What are the 4 features in aneurysm formation?

A
  1. Annormal dilatation of artery
  2. Weakening of media by atherosclerosis
  3. Elastic degeneration and fragmentation-loss of stretch/recoil
  4. Abdominal aorta
64
Q

What are these causes of - congenital, berry aneurysm and subarachnoid haemorrhage, syphylitic, mycotic and iatrogenic?

A

Abnormal dilatation of artery

65
Q

What are 3 complications of aneurysm?

A
  1. Rupture
  2. Thrombosis
  3. Embolism
66
Q

What are three features of arterial dissection?

A
  1. Splitting within the media by following blood
  2. False lumen filled with blood within the media
  3. Sudden collapse
67
Q

What is likely to occur in middle aged patients with/without atheroma?

A

Arterial dissection

68
Q

What are these potential causes of - atheroma, hypertension, trauma, coarctation, marfan’s and pregnancy?

A

Aortic dissection

► Med - Anatomy & Physiology (130 decks)

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